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Required format:

6cVR2yFrrzu7suIULojUNKvC7e7mp3I6

MHAP Provider Training Registration

Dear Participant,

Please fill out this brief form to sign up for a training. The form will take you 5 minutes to complete.

Please provide your current email, as a post-training evaluation survey will be delivered to your inbox. The purpose of the post-training evaluation survey is to help us customize the trainings to best support you. Your feedback is valued! No identifiable data will be shared with MHAP program. Your confidentiality is secured by UMKC-IHD (MHAP Evaluation Team).

If you have questions about the training, please contact: musompsychiatrymh1@missouri.edu to reach the program, or mhap_ihd@umkc.edu to reach the evaluation team for anonymous feedback.

Thank you!

SUCCESSFUL COMPLETION

Successful completion of this activity, which includes registering to attend, participating in the educational offering, participating in the evaluation process and completing the verification of attendance, enables the learner to satisfy the requirements for continuing education. Must complete 72-minutes of the 90-minute webinar to claim education credits.

Today's date

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M-D-Y

First name

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Last name

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Zip code

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Sex

Male

Female

Not listed

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Select the option that best describes your gender identity:

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Male or Cis Male (I am a man and this matches the gender listed on my birth certificate)

Trans Male (I am a man and this does not match the gender listed on my original birth certificate)

Female or Cis Female (I am a woman and this matches the gender listed on my birth certificate)

Trans Female (I am a woman and this does not match the gender listed on my original birth certificate)

Non-binary/genderqueer/gender non-conforming (my gender identity doesn't fit within the traditional binary of man and woman)

Prefer not to share

I prefer other terminology

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If you prefer other terminology, please specify

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Are you Hispanic/Latino?

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Yes

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Select the race(s) that best describe how you identify. (Select all that apply)

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American Indian or Alaskan Native

Asian or Asian American

Black or African American

Native Hawaiian or other Pacific Islander

White or Caucasian

Other

Profession/Provider Type/Role

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988 Staff

Pediatrician

Family Medicine

OB/GYN

Internal Medicine

Advanced Practice Nurse/Nurse Practitioner

Certified Nurse Midwife

Physician Assistant

Psychiatrist

Developmental-Behavioral Pediatrician

Nurse

Behavioral Health Clinician (e.g. psychologist, therapist, counselor)

Care Coordinator/Patient Navigator

Doula

School Professional

Other Administrative Role (DESE, DMH, etc.)

Other Types of Specialty Physician, APNNP, PA providers

Other

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What type of School Professional?

school nurse

school counselor

school social worker

school administrator

teacher

other

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Session Name - For 988 Crisis Workers Only

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May 6, 7:00 PM - 8:00 PM: 988 Perinatal Mental and Behavioral Health Training

May 22, 9:00 AM - 10:00 AM: 988 Perinatal Mental and Behavioral Health Training

May 8, 6:00 PM - 8:00 PM: 988 Perinatal Mental and Behavioral Health Training (DeafLEAD Only)

May 16, 3:00 PM - 5:00 PM: 988 Perinatal Mental and Behavioral Health Training (DeafLEAD Only)

Session Name: Screening, Assessing, and Managing Perinatal Anxiety Disorders

Please note that, while you are welcome to register for both sessions, the majority of the content presented in the two sessions will be the same. Session A will include additional content on non-pharmacologic interventions, while Session B will include additional content on medication interventions.

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October 28, 11:00 AM - 12:00 PM: Emphasis on Non-Pharmacologic Interventions (Session A)

October 29, 12:00 PM - 1:00 PM: Medication Management Component (Session B)

Please select the training(s) you would like to attend.

NOTE: We encourage everyone to take Part 1. Part 2 is more geared towards prescribers, but will be good information too. If you are a prescriber, we highly recommend you to take both!

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January 28, 12-1 P.M.: Part 1 - Screening and Diagnosis of Substance Use Disorders in Pregnancy and Postpartum

January 29, 12-1 P.M.: Part 2 - Treatment of Substance Use Disorders During Pregnancy and Postpartum

Please select the trainings you would like to attend.

Note: Both sessions will focus heavily on medication management and may be most relevant for prescribing professionals

Monday, April 28, 12-1:30 PM: Assessment and Treatment of Depression in Preconception Planning

Tuesday, April 29, 12-1:30 PM: Treatment of Depression During the Perinatal Period

Please select the trainings you would like to attend in May 2025.

Thursday, May 29, 12-1:00 PM: 988 Perinatal Mental and Behavioral Health Training

Please select the trainings you would like to attend in July 2025.

Tuesday July 29, 12-1:30 PM: Responding to Addiction Part 1

Wednesday July 30, 12-1:30 PM: Responding to Addiction Part 2

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.